Family structure, sociodemographic factors and type of dental service associated with oral health literacy in the early adolescence

Lopes, Roanny Torres; Neves, Érick Tássio Barbosa; Gomes, Monalisa Cesarino; Paiva, Saul Martins; Ferreira, Fernanda Morais; Granville-Garcia, Ana Flávia

doi:10.1590/1413-812320212611.3.34782019

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FREE THEMES • Ciênc. saúde coletiva 26 (suppl 3) • 2021 • https://doi.org/10.1590/1413-812320212611.3.34782019 copy

Family structure, sociodemographic factors and type of dental service associated with oral health literacy in the early adolescence

Estrutura familiar, fatores sociodemográficos e tipo de serviço odontológico associados ao alfabetismo em saúde bucal no início da adolescência

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this study was to evaluate associations between oral health literacy and family, sociodemographic and dental service characteristics in early adolescents. A cross-sectional study was conducted with 740 schoolchildren. The following variables were investigated using validated questionnaires: oral health literary (BREALD-30), sociodemographic characteristics, type of dental service and family functioning (FACES III). Associations were tested using robust Poisson regression analysis (α=5%). Higher oral health literacy was associated with the female sex (RR=1.09; 95%CI: 1.03-1.14), connected type of family cohesion (RR=1.12; 95%CI: 1.05-1.20), rigid (RR=1.14; 95%CI: 1.04-1.25) and structured (RR=1.11; 95%CI: 1.04-1.20) types of family adaptability, more than eight years of mother’s schooling (RR=1.16; 95%CI: 1.10-1.22), age of caregiver more than 38 years (RR=1.07; 95%CI: 1.02-1.13) and the use of private dental services (RR=1.06; 95%CI: 1.01-1.12). The level of oral health literacy in early adolescents was associated with sex, family structure, mother’s schooling, caregiver’s age and type of dental service used.

Key words:
Oral Health; Health literacy; Adolescent health; Adolescent; Family relations

Variables		Frequency
Variables		n	%
Sex
	Female	420	56.8
	Male	320	43.2
Ethnicity/self-declared skin colour
	White	215	29.1
	Non-white	525	70.9
Position in family
	Only child	6	0.8
	Oldest child	261	35.3
	Middle child	174	23.5
	Youngest child	299	40.4
Mother’s schooling
	≤8 years of study	426	58.0
	>8 years of study	308	42.0
Caregiver’s age
	<38 years	360	49.0
	≥39 years	374	51.0
Social class
	Class A	17	2.3
	Class B1-B2	174	23.6
	Class C1-C2	358	48.5
	Class D and E	189	25.6
Number of residents in home
	≤5	577	79.3
	>6	151	20.7
Caregiver’s marital status
	Married	419	56.8
	Single, divorced, widowed	319	43.2
Family cohesion
	Enmeshed	14	1.9
	Connected	87	11.8
	Separated	293	39.6
	Disengaged	346	46.8
Family adaptability
	Rigid	90	12.2
	Structured	226	30.5
	Flexible	230	31.1
	Chaotic	194	26.2
Type of dental service used
	Public	229	41.7
	Private	320	58.3

Variables		Oral health literacy	Bivariate		Multivariate
		Mean (SD)	Unadjusted Rate Ratio (RR)*		Adjusted Rate Ratio (RR)†
		Mean (SD)	(95%CI)	p-value	(95%CI)	p-value
Sex
	Male	16.42 (5.81)	1.00		1.00
	Female	17.49 (5.87)	1.06 (1.01-1.12)	0.001	1.09 (1.03-1.14)	0.001
Ethnicity/skin colour
	White	17.90 (5.59)	1.07 (1.02-1.13)	0.007	-	-
	Non-white	16.67 (5.94)	1.00		-	-
Position in family
	Only child	20.83 (6.43)	1.21 (0.96-1.52)	0.102	-	-
	Oldest child	17.38 (5.73)	1.01 (0.95-1.06)	0.724	-	-
	Middle child	16.05 (6.00)	0.93 (0.87-0.99)	0.042	-	-
	Youngest child	17.21 (5.84)	1.00		-	-
Mother’s schooling
	≤8 years of study	15.46 (5.97)	1.00		1.00
	>8 years of study	19.24 (4.96)	1.24 (1.18-1.30)	<0.001	1.16 (1.10-1.22)	<0.001
Caregiver’s age
	≤38 years	16.24 (5.95)	1.00		1.00
	>38 years	17.94 (5.72)	1.09 (1.04-1.15)	<0.001	1.07 (1.02-1.13)	0.004
Number of residents in home
	≤5	17.39 (5.74)	1.10 (1.03-1.18)	0.005	-	-
	>5	15.75 (6.21)	1.00		-	-
Caregiver’s marital status
	Married	17.79 (5.79)	1.10 (1.05-1.16)	<0.001	-	-
	Single/divorced/widowed	16.09 (5.79)	1.00		-	-
Social class
	Class A	19.06 (3.64)	1.31 (1.17-1.46)	<0.001	-	-
	Class B1-B2	18.86 (4.66)	1.29 (1.20-1.39)	<0.001	-	-
	Class C1-C2	17.41 (5.62)	1.19 (1.11-1.28)	<0.001	-	-
	Class D-E	14.52 (6.54)	1.00		-	-
Type of dental service used
	Public	16.41 (5.90)	1.00		1.00
	Private	18.37 (5.30)	1.11 (1.05-1.18)	<0.001	1.06 (1.01-1.12)	0.024
Family cohesion
	Enmeshed	17.86 (7.89)	1.09 (0.87-1.37)	0.428	1.13 (0.95-1.33)	0.145
	Connected	18.89 (4.70)	1.15 (1.08-1.23)	<0.001	1.12 (1.05-1.20)	<0.001
	Separated	17.30 (5.57)	1.06 (1.01-1.12)	0.03	1.05 (0.99-1.11)	0.067
	Disengaged	16.29 (6.17)	1.00		1.00
Family adaptability
	Rigid	18.28 (5.58)	1.14 (1.05-1.24)	0.001	1.14 (1.04-1.25)	0.003
	Structured	18.01 (5.57)	1.12 (1.05-1.20)	<0.001	1.11 (1.04-1.20)	0.002
	Flexible	16.47 (5.70)	1.03 (0.96-1.10)	0.376	1.04 (0.97-1.12)	0.179
	Chaotic	15.95 (6.27)	1.00		1.00

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[1] Collaborations

RT Lopes, ETB Neves, MC Gomes, SM Paiva, FM Ferreira and AF Granville-Garcia worked on the conception and design or analysis and interpretation of data. RT Lopes, ETB Neves, AF Granville-Garcia and FM Ferreira worked on drafting the article or revising it critically. ETB Neves, AF Granville-Garcia, FM Ferreira and SM Paiva worked on the research and the methodology. RT Lopes, ETB Neves, MC Gomes, SM Paiva, FM Ferreira and AF Granville-Garcia approved the final version to be published.